European Journal of Pediatrics最新文献

{"title":"Usefulness of urinary β2-microglobulin for diagnosing acute focal bacterial nephritis.","authors":"Kisho Shimura, Ryosuke Fukushima, Takuma Sakon","doi":"10.1007/s00431-025-06106-8","DOIUrl":"https://doi.org/10.1007/s00431-025-06106-8","url":null,"abstract":"<p><p>In this study, we aimed to evaluate the usefulness of urinary β2-microglobulin (U-β2MG) for diagnosing acute focal bacterial nephritis (AFBN) among upper urinary tract infections (UTIs). This retrospective study was performed at a single institution and included patients younger than 16 years of age diagnosed with upper UTIs. Patients were divided into the AFBN group and acute pyelonephritis (APN) group. Levels of U-β2MG corrected using urinary creatinine (U-β2MG/Ucre) were compared between groups. A multiple regression analysis was performed using Log(U-β2MG/Ucre) as a dependent factor and the diagnosis (AFBN or APN), age, sex, hydronephrosis grade, urinary pH, and fever interval before admission as independent factors. To discriminate AFBN and APN, thresholds of U-β2MG/Ucre and C-reactive protein (CRP) levels were measured using the receiver-operating characteristic curve. Nineteen patients and 37 patients with AFBN and APN, respectively, were analyzed. The U-β2MG/Ucre level differed significantly between the AFBN and APN groups (10762 μg/gCr vs. 1525 μg/gCr, respectively; P = 0.007). The multiple regression analysis indicated that the Log(U-β2MG/Ucre) value of the AFBN group was considerably higher than that of the APN group (P = 0.004). The threshold values of U-β2MG/Ucre and CRP levels were 2070 μg/gCr and 5.7 mg/dL, respectively. Sensitivity and specificity were 0.95 and 0.68, respectively, when both thresholds were used.Conclusions: The U-β2MG/Ucre level of patients with AFBN was significantly higher than that of patients with APN. Therefore, U-β2MG/Ucre could be used to discriminate between AFBN and APN. What is Known: • U-β2MG can aid in discriminating between upper and lower UTIs; however, using both U-β2MG and procalcitonin allows for more accurate differentiation What is New: • U-β2MG may be useful for discriminating between AFBN and APN in upper UTIs. Assessing both U-β2MG and CRP levels may improve the diagnosis of AFBN without invasive imaging tests.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 5","pages":"276"},"PeriodicalIF":3.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of duodenal bulb biopsies in histological diagnosis of coeliac disease.","authors":"M Ahmed, T Tolufase, P Gill, M I Sayed","doi":"10.1007/s00431-025-06113-9","DOIUrl":"10.1007/s00431-025-06113-9","url":null,"abstract":"<p><p>Coeliac disease is an autoimmune condition with variable presentation which leads to difficulties and delays in diagnosis. A retrospective study was undertaken to investigate the effectiveness of duodenal bulb biopsies in histologic diagnosis of coeliac disease. Histology specimens were analysed from 230 patients, age ranging from 0 to 16 years over a 10-year period (2014-2024) who had raised tissue transglutaminase/endomysial antibodies and were referred for an upper gastrointestinal endoscopy to confirm/rule out coeliac disease. Biopsies taken from the proximal (D1) and distal duodenum (D2, 3, 4) were compared in 145 children who were confirmed to have the diagnosis of coeliac disease on histopathology. The results revealed that a significant number of children (56/145; 38.6%) had positive histological changes seen in proximal duodenum only with completely normal histology in distal duodenum. In comparison, only 4/145 (2.8%) children yielded positive histology result from distal duodenum with normal proximal duodenal biopsies. Proximal duodenal segment histology samples therefore had the highest sensitivity (97%), negative predictive value (95.5%), and accuracy (98%).</p><p><strong>Conclusion: </strong> Our fundings re-enforce the importance of obtaining an adequate number of proximal duodenal samples for histological analysis in children investigated for coeliac disease in order to avoid delayed or missed diagnosis in this age group.</p><p><strong>What is known: </strong>• Coeliac disease affects 1-2% of western population though prevalence varies by the region. • A sub-set of suspected cases with anti-tissue transglutaminase (TTG) antibody titres of less than ten times the upper limit of normal require duodenal biopsies for confirmation of diagnosis.</p><p><strong>What is new: </strong>• Duodenal bulb biopsies have higher sensitivity and negative predictive value when compared to distal duodenal biopsies. • Endoscopist must obtain adequate number of samples from proximal duodenum (duodenal bulb) to avoid false negative results.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 5","pages":"277"},"PeriodicalIF":3.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myelin oligodendrocyte glycoprotein antibody-associated meningoencephalitis without cerebral parenchyma involvement on MRI: A single-centre paediatric cohort study.","authors":"Ren Changhong, Liu Ming, Zhou Anna, Zhou Ji, Zhuo Xiuwei, Tian Xiaojuan, Yang Xinying, Gong Shuai, Fang Fang, Ren Xiaotun, Zhang Weihua","doi":"10.1007/s00431-025-06071-2","DOIUrl":"https://doi.org/10.1007/s00431-025-06071-2","url":null,"abstract":"<p><p>Since meningoencephalitis with prominent meningeal involvement was first described as a rare phenotype of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), sporadic cases have been reported. However, most of the reports were case reports and small sample cohorts. We conducted a retrospective analysis of paediatric patients with MOG antibody-associated meningoencephalitis without cerebral parenchyma involvement on imaging at Beijing Children's Hospital between 2017 and 2024. Upon reviewing the records of 320 MOG antibody-positive paediatric patients in our centre, we identified 18 (6%) patients (median age, 7.2 years; female, 10) with disease onset. The common clinical symptoms were fever (94%), headache (56%), seizure (44%) and vomiting (44%). Most patients had leukocytosis (78%) and elevated ESR and CRP levels (61%). Cerebrospinal fluid analysis revealed intracranial hypertension (28%), leukocytosis (100%) and elevated protein levels (33%). Negative cranial magnetic resonance images were observed in 4 patients, and meningeal enhancement was observed in 14 patients. Fourteen patients showed no improvement with antibiotic therapy but responded effectively to immunotherapy. After a median follow-up of 22 months, 4 (22%) of the 18 patients experienced relapse. At the time of the last follow-up, all patients had a good prognosis (mRS < 2). Conclusion: Meningoencephalitis without parenchymal involvement on MRI represents an underrecognized MOGAD phenotype. The incorporation of this entity into diagnostic criteria and the initiation of early immunotherapy could increase diagnostic sensitivity and reduce relapse risk in children.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 5","pages":"275"},"PeriodicalIF":3.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel conditioning regimen involving haploid immune cell infusion combined with umbilical cord blood transplantation for the treatment of juvenile myelomonocytic leukemia.","authors":"Tianqi Liang, Chunfu Li, Yun Chen, Yuelin He, Chun Chen, Sa Zong, Haoran Tang, Yanru Pei, Dan Yue, Yuming Zhao, Yong Liu, Zhiyong Peng","doi":"10.1007/s00431-025-06109-5","DOIUrl":"https://doi.org/10.1007/s00431-025-06109-5","url":null,"abstract":"<p><p>Juvenile myelomonocytic leukemia (JMML) is a rare and highly malignant hematological tumor that occurs in children. Allogeneic hematopoietic stem cell transplantation remains the primary treatment for the vast majority of children with JMML. However, busulfan-based myeloablative conditioning regimens do not effectively solve the problem of low survival and high recurrence rates after transplantation. We previously achieved good results in the treatment of JMML with complementary transplantation and found that only one of the five patients who relapsed had umbilical cord blood (UCB) engraftment (blood 2019 134:4181). To further investigate the feasibility of UCB transplantation in JMML, we developed a novel regimen and performed a long-term follow-up analysis to evaluate its effectiveness and safety. In this multicenter, single-arm, retrospective clinical study, 17 children with JMML were treated with a novel regimen consisting of haploid immune cell infusion combined with UCB transplantation. After a median follow-up of 48 months, relapse was observed in 1 in 17 patients, with a cumulative relapse incidence rate of 6.7%. The 5-year overall and event-free survival rates were 87.4% and 82.4%, respectively. Among the included patients, seven experienced grade II-IV acute graft-versus-host disease (GVHD), including two patients with grade III-IV acute GVHD, resulting in cumulative incidence rates of 41.0% and 11.8%, respectively. Additionally, a total of two patients in the cohort developed chronic GVHD, and the cumulative incidence of chronic GVHD at 5 years was 11.8%. Conclusion: Our results suggest that, combined with a suitable regimen, UCB transplantation may be an effective and safe option for the treatment of JMML.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 5","pages":"274"},"PeriodicalIF":3.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shedding light on eating disorders in adolescents with type 1 diabetes: insights and implications.","authors":"Sohier Yahia, Nanees A Salem, Salwa Tobar, Zahraa Abdelmoneim, Ahmed Magdy Mahmoud, Wafaa Laimon","doi":"10.1007/s00431-025-06081-0","DOIUrl":"10.1007/s00431-025-06081-0","url":null,"abstract":"<p><p>Eating disorders (EDs) are complex medical conditions that pose a considerable health burden for individuals with type 1 diabetes mellitus (T1DM). EDs in individuals with T1DM are linked to poor metabolic control, which heightens the risk of diabetes complications. Consequently, regular screening for EDs is essential. This study investigates the prevalence of EDs in adolescents with T1DM, investigating the associations with diabetes duration, pubertal stage, glycemic control, and diabetes-related complications. In this cross-sectional study, 350 adolescents (155 males, 195 females) with T1DM, aged 12-18, were recruited from Mansoura University Children's Hospital. Participants completed the Diabetes Eating Problem Survey-Revised (DEPS-R) questionnaire, with scores ≥ 20 prompting clinical interviews to confirm EDs. Clinical data, including HbA1c, BMI, and body composition, were analyzed. Socioeconomic status (SES) and family factors were assessed. The prevalence of EDs was 22.6%, including other specified feeding or eating disorders (OSFED) (68.4%), binge eating (11.4%), bulimia nervosa (7.6%), avoidant restrictive (7.6%), and anorexia nervosa (5.1%). Binary logistic regression analysis showed that the significant predictors of ED in the study cohort were diabetes duration (OR = 1.75 (1.66-1.84), p < 0.001), and HbA1c (OR = 5.94 (2.4-14.6), p < 0.001). Conclusions: Adolescents with EDs had higher (SES), more family conflicts, longer diabetes duration, and were more prone to diabetic nephropathy and poor glycemic control. Screening for EDs is recommended from pre-adolescence through early adulthood. What Is Known: • Adolescents with T1DM are more vulnerable to develop EDs compared to their peers without T1DM What Is New: • The DEPS-R and DSM-V were useful clinical tools for screening and for diagnosis of EDs respectively among adolescents with T1DM • We advise to screen for EDs in adolescents with T1DM who aged around 13.6 years, at Tanner stage 3, with duration of T1DM >5 years, and/or with HbA1c >7.5.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 4","pages":"272"},"PeriodicalIF":3.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11958379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healing bonds: the complex experiences of pediatric sibling stem cell donors.","authors":"Camie Thys, Patricia Devos, Liesbet Goubert, Sophie Van Lancker, Fleur Baert, Chiara Roebben, Catharina Dhooge, Victoria Bordon","doi":"10.1007/s00431-025-06094-9","DOIUrl":"https://doi.org/10.1007/s00431-025-06094-9","url":null,"abstract":"<p><p>Previous research has explored the experiences of sibling pediatric stem cell donors; gaps remain, particularly regarding children and adolescents in Belgium who donate to severely ill siblings. This study examines their personal and relational experiences through qualitative analysis. Semi-structured interviews with 13 donors revealed a mix of eagerness and obligation-while they were willing to help, many felt they had no choice and were often overlooked. Findings highlight a lack of post-donation support and the need for greater recognition of donors' experiences. Despite improvements in pre-donation care, enhanced post-donation support remains crucial. A structured, personalized approach is recommended.Conclusion: Enhanced post-donation support is essential to address the emotional and psychological impact on sibling donors. Further research should explore how donor age and recipient outcomes shape the donation experience.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 4","pages":"273"},"PeriodicalIF":3.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overweight and obesity in early childhood and obesity at 10 years of age: a comparison of World Health Organization definitions.","authors":"Andraea Van Hulst, Sophie Zheng, Nikolas Argiropoulos, Marina Ybarra, Geoff D C Ball, Lisa Kakinami","doi":"10.1007/s00431-025-06098-5","DOIUrl":"https://doi.org/10.1007/s00431-025-06098-5","url":null,"abstract":"<p><p>The World Health Organization recommends using + 2 SD of body mass index z-score (zBMI) to define overweight/obesity (OWO) in children ages 2 to 5 years whereas + 1 SD is used as cut-point from 5 years onwards. Empirical evidence for using different cut-points across childhood is lacking. Our objective was to compare the ability of OWO in early childhood defined using zBMI cut-points at + 2 SD and + 1 SD to predict obesity at 10 years. Data from a prospective birth cohort (QLSCD) were analyzed. At ages 2.5, 3.5, and 4.5 years, children were classified as OWO based on + 2 SD and + 1 SD zBMI cut-points. At 10 years, obesity was assessed (zBMI and waist circumference). Associations between OWO (vs non-OWO) and later obesity were estimated using multivariable linear regressions. Outcome predictions for each cut-point were compared using partial eta-squared values. The sample included 1092 children (53% female). OWO in early childhood was 2-3 times more prevalent when using + 1 SD vs + 2 SD cut-points. In relation to later obesity, partial eta-squared values for both cut-points of OWO were in the small to medium effect size range (ranging from 3 to 15%), suggesting that OWO regardless of cut-point contributed only modestly to obesity measured at 10 years. However, across all time points, eta-squared values were slightly higher for OWO defined at + 1 SD vs + 2 SD, indicating a higher proportion of variance in outcomes being accounted for at zBMI + 1 SD. Conclusion: In children 2 to 5 years old, both definitions of OWO had small to modest effect sizes in relation to obesity in childhood albeit with a marginally superior predictive ability of the + 1 SD over the + 2 SD cut-point across early childhood. From a clinical perspective, using a single cut-point from early childhood onwards may be more practical to monitor growth and weight gain over time and identify children at risk of persistent obesity. What is Known: • The World Health Organization recommends using zBMI cut-points at + 2 SD for children ages 2-5 years, and + 1 SD from 5 years onwards to define overweight/obesity • Research is needed to determine which zBMI cut-point (+ 2 SD or + 1 SD) in children under 5 years best predicts subsequent obesity What is New: • Both definitions of overweight/obesity in early childhood contributed modestly to obesity at 10 years, with + 1 SD being marginally more effective than + 2 SD • Using a single cut-point at + 1 SD across childhood may be more practical for monitoring growth, weight gain, and identifying children at risk of persistent obesity.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 4","pages":"270"},"PeriodicalIF":3.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical delineation and genotype-phenotype correlation in 104 children with kabuki syndrome: A single-center, cross-sectional and follow-up study in China.","authors":"Yirou Wang, Feihan Hu, Xueqiong Xu, Jun Tan, Tingting Yu, Niu Li, Qian Li, Yao Chen, Guoying Chang, Xiuqi Ma, Ding Yu, Xiumin Wang","doi":"10.1007/s00431-025-06103-x","DOIUrl":"10.1007/s00431-025-06103-x","url":null,"abstract":"<p><p>This study provides a detailed genotype and phenotype analysis of a large longitudinal cohort of Kabuki Syndrome (KS) from a single center in China. From July 2017 to July 2024, participants were enrolled at Shanghai Children's Medical Center. Variants in KMT2D or KDM6A were identified through whole exome sequencing. Phenotype data included prenatal and perinatal history, neonatal, childhood and adolescence evaluations. A total of 104 KS individuals fullfiled 362 outpatient visits, with an average follow-up of 2.58 years and a median follow-up time of 1.75 years. Growth curves were plotted based on 433 height data points. Among the patients, 27.08% had congenital heart defects (CHD), and 3 patients were identified with anomalous pulmonary venous connection as a new KS phenotype. KS patients showed facial feature heterogeneity, patients with atypical facial features associated with a older diagnosis age and a more diverse and severe phenotype. Among the 99 KS patients who provided facial photographs, the Face2Gene software was able to make accurate diagnoses in 85 individuals. The remaining 14 individuals may have had incorrect diagnoses because the provided photographs were not frontal facial images.</p><p><strong>Conclusion: </strong>This study offered a comprehensive description of a Chinese KS cohort, and provided the first growth curves and a detailed CHD phenotype spectrum of Chinese KS patients. Our findings also suggest that, despite requirements for photograph quality, facial recognition software will be of significant value in the clinical diagnosis of KS.</p><p><strong>What is known: </strong>• Kabuki syndrome is a rare disease that affects multiple systems. • Short stature is one of the common clinical manifestations of Kabuki syndrome.</p><p><strong>What is new: </strong>• The genotypes and phenotypes of patients with Kabuki syndrome in China have been described in detail. • Growth curves for patients with Kabuki syndrome in China have been established.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 4","pages":"271"},"PeriodicalIF":3.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: A global cross-sectional survey on neonatal analgosedation: unveiling global trends and challenges through latent class analysis.","authors":"Cristina Arribas, Giacomo Cavallaro, Nunzia Decembrino, Juan Luis González, Carolina Lagares, Genny Raffaeli, Anne Smits, Sinno P H Simons, Eduardo Villamor, Karel Allegaert, Felipe Garrido","doi":"10.1007/s00431-025-06100-0","DOIUrl":"10.1007/s00431-025-06100-0","url":null,"abstract":"","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 4","pages":"269"},"PeriodicalIF":3.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction of fruit juice and sugar-sweetened beverages before 6 months of age and early childhood caries at 3.5 years: the ELFE cohort study.","authors":"Joséphine Kerguen, Cathy Nabet, Sylvie Azogui-Lévy, Anne-Laure Bonnet, Sibylle Vital, Véronique Pierrat, Monique Kaminski, Marie-Noelle Dufourg, Alice Germa","doi":"10.1007/s00431-025-06093-w","DOIUrl":"https://doi.org/10.1007/s00431-025-06093-w","url":null,"abstract":"<p><p>The aim of this study was to investigate the relationships between the introduction of fruit juice or sugar-sweetened beverages (SSBs) before the age of 6 months and the presence of early childhood caries (ECC) at 3.5 years of age. The study is based on data from the population-based nationwide prospective cohort study ELFE (French Longitudinal Study of Children). Children were recruited at birth in 2011 in France. Detailed data on the children's diets, as well as socio-economic characteristics and dental caries at 3.5 years, were prospectively collected through online questionnaires and telephone interviews of the parents. The primary outcome was the presence of ECC reported by the parents at 3.5 years. The main exposure was the introduction of fruit juice or SSBs before the age of 6 months into the child's diet. Among the 10,921 children included, 1955 (19.5%) were exposed to fruit juice or SSBs before 6 months of age and 229 (3.0%) had ECC; 53 (4.7%) of exposed children and 176 (2.5%) of those not exposed had ECC at 3.5 years of age. Based on multivariable analysis, introduction of fruit juice or SSBs before 6 months of age was associated with ECC at 3.5 years (adjusted OR = 1.5, 95% CI [1.1, 2.2]).</p><p><strong>Conclusion: </strong>This study indicates that early introduction of fruit juice or SBBs is associated with an increased risk of developing ECC, highlighting the need for early prevention by childhood professionals and nationwide prevention campaigns.</p><p><strong>What is known: </strong>• Consumption of SSBs is a well-known risk factor for dental caries in children, yet fruit juices still culturally maintain a healthy image. • Limited data on ECC risk factors in children under 4 years have been published.</p><p><strong>What is new: </strong>• The very early introduction of fruit juices or SSBs into a child's diet is later associated with ECC at 3.5 years. • This study is the first to investigate complementary feeding in relation to ECC before the age of 4 using a nationwide population-based design.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 4","pages":"268"},"PeriodicalIF":3.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}